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Received July 20, 2005
Accepted on December 13, 2005

ORIGINAL ARTICLES

Improvement in Hypercalcemia with Cinacalcet after Kidney Transplantation

Titte R. Srinivas ^*1, Jesse D. Schold ^*, Karl L. Womer , Bruce Kaplan ^*, Richard J. Howard , Charles M. Bucci ^*, and Herwig-Ulf Meier-Kriesche ^*

*Divisions of Nephrology, Hypertension and Transplantation and Nephrology and Department of Surgery, University of Florida, Gainesville, Florida; and Division of Nephrology, Gainesville Veterans Affairs Medical Center and University of Florida, Gainesville, Florida

¹ To whom correspondence should be addressed. E-mail: srinitr{at}medicine.ufl.edu.

	Abstract

Cinacalcet, a calcimimetic, was evaluated in persistent hyperparathyroidism after kidney transplantation (Tx). Ten kidney transplant recipients and one kidney-pancreas recipient with persistent post-Tx hypercalcemia (serum calcium [SCa] > 10.2 mg/dl), stable graft function, and intact parathyroid hormone (iPTH) 2 times normal received 30 mg/d cinacalcet between 2 mo and 5 yr after Tx. SCa, serum phosphorus (SP), and iPTH were measured before and after cinacalcet. Mean pre-cinacalcet SCa was 10.9 mg/dl (8.6 to 11.9 mg/dl). Average pre-cinacalcet SP was 2.9 mg/dl (1.8 to 4.0 mg/dl). Mean pre-cinacalcet iPTH was 267.0 pg/ml (99 to 723 pg/ml). After cinacalcet, SCa decreased on average by 1.6 mg/dl (95% confidence interval 1.2 to 2.1; P < 0.0001). Post-cinacalcet SP increased on average 0.45 mg/dl (P = 0.046). Post-cinacalcet iPTH averaged 156.9 mg/dl (P = 0.10). Graft function remained stable. Cinacalcet lowers SCa and raises SP in the short term in patients with persistent post-Tx hyperparathyroidism; long-term bone effects and persistent hyperparathyroidism merit further study.

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